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目的:探讨低位直肠癌保肛术后吻合口漏的原因及合理有效的防治方法.方法:对低位直肠癌全系膜切除低位吻合手术后吻合口漏的发生及治疗情况进行回顾性分析.对吻合口漏的患者采用手术及保守治疗(骶前双腔管冲洗引流加肛管引流).结果:共行低位保肛手术412例,术后发生吻合口漏9例(2.2%).患者的年龄、吻合技术和肿瘤组织学分型与吻合口漏的发生无关.而患者的性别、肿瘤的大小与吻合口漏的发生密切相关(P<0.05).行手术治疗(HA手术)2例,采用保守治疗7例均痊愈出院,吻合口漏发生至出院时间10~15d.结论:充分的术前准备和良好的吻合技术是防止吻合口漏发生的关键.正确的判断吻合口漏发生及采用正确的处理方法是治疗的前提,双腔引流管加肛管引流是保守治疗吻合口漏的有效方法.
Objective: To investigate the causes of anastomotic leakage after anus-preserving surgery in low rectal cancer and the reasonable and effective methods of prevention and treatment.Methods: The incidence and treatment of anastomotic leakage after low-level anastomosis of total rectal cancer were retrospectively analyzed. Anastomotic leakage was treated by surgery and conservative treatment (pre-sacral double-lumen tube irrigation and drainage plus anal canal drainage) .Results: There were 412 cases of anus-preserving surgery and 9 cases (2.2%) of anastomotic leakage occurred after operation Age, anastomosis technique and tumor histological type had no relation with the occurrence of anastomotic leakage, while the gender and size of the tumor were closely related to the occurrence of anastomotic leakage (P <0.05) .2 cases underwent surgical treatment (HA surgery) Conservative treatment of seven cases were cured, anastomotic leakage occurred to the discharge time of 10 ~ 15d.Conclusion: adequate preoperative preparation and good anastomosis is the key to prevent the occurrence of anastomotic leakage.A correct judgment of anastomotic leakage and the use of correct Treatment is the premise of treatment, double-lumen drainage tube plus anal canal drainage is an effective method of conservative treatment of anastomotic leakage.